Diagnostic Imaging Staff

Magnetic resonance imaging is comparable to fluorine 18 fluorodeoxyglucose PET/CT in determining if pulmonary lesions are malignant or benign, according to a study published in the journal 

Researchers from Brazil, the United States, and the United Kingdom performed a literature meta-analysis to compare how the diagnostic performance of fluorine 18 fluorodeoxyglucose 

 and diffusion-weighted (DW) MRI differed in determining malignant and benign pulmonary nodules and masses.

The researchers focused on studies that where DW MRI and PET/CT were performed in the entire study population:

Lesion-to–spinal cord signal intensity ratio and apparent diffusion coefficient were evaluated for DW MRI

Maximum standard uptake value was evaluated for PET/CT

The pooled sensitivities, specificities, diagnostic odds ratios, and areas under the receiver operating characteristic curve (AUCs) for PET/CT and DW MRI were determined.

The results showed that the 37 studies that met the inclusion criteria and a total of 4,224 participants and 4,463 lesions; 3,090 of the lesions were malignant (69.2%).

Study: In-Hospital MRIs Could Be Wasteful

The primary analysis of the 6 joint DW MRI and PET/CT studies showed that DW MRI had a pooled sensitivity of 83% and specificity of 91%, compared with a pooled sensitivity of 78% and specificity of 81% for PET/CT. DW MRI yielded an AUC of 0.93  versus 0.86 for PET/CT. The diagnostic odds ratio of DW MRI (50) was superior to that of PET/CT (15).

The researchers concluded that the diagnostic performance of diffusion-weighted MRI was comparable or superior to that of fluorine 18 fluorodeoxyglucose PET/CT when differentiating between malignant and benign pulmonary lesions.

Articles

Diagnostic performance is comparable to fluorine 18 fluorodeoxyglucose PET/CT in diagnosing pulmonary lesions.

Diffusion-Weighted MRI Can Characterize Pulmonary Lesions

Magnetic resonance imaging is useful in detecting potential predisposing conditions and complications that could correlate with return to play (RTP) among professional football players, according to a study published in the journal 

Researchers from Italy sought to determine if they could identify a correlation between RTP and sports-related injuries using MRI, which is already the gold-standard for evaluating and classifying acute injuries to the adductor longus (AL).

MRI Shows Acute, Chronic Changes in Myelin in Contact-Sport Athletes

The study included 20 professional soccer players who presented with acute groin pain and for whom there was clinical suspicion of AL injury related to their sport. All underwent MRIs which were performed by one radiologist and reviewed by two others. Lesions were stratified according to both 

 and British Athletics Muscle Injury Classification (

More than 6 weeks for complete lesions (25%)

“Both BAMIC and Munich consensus significantly correlated with RTP,” the authors wrote. “The extent of gap was the only independent prognosticator of RTP always present in all three different models of multivariate analysis.”

The researchers concluded that aside from using MRI to evaluate AL and classify acute lesions, the imaging could help detect potential predisposing conditions and complications, which may correlate with RTP.

Magnetic resonance imaging is already the gold standard imaging technique for the evaluation of AL.

MRI May Help Determine Return to Play After Adductor Longus Injury

Unenhanced CT attenuation in adrenal adenoma (AA) can be affected by lipid-metabolism-related factors, according to a study published in the journal 

Researchers from Japan sought to determine if lipid metabolism-related factors regulated unenhanced CT attenuation in AA. A total of 36 with surgically proven AAs participated in the study. The underlying diseases in the group were:

Subclinical Cushing’s syndrome, 3 patients

The researchers measured unenhanced CT attenuation of the AAs and the liver. Pathologically, clear cell ratio (CCR) constituting each AA was qualitatively assessed. The researchers also obtained clinical data including tumor diameter, body mass index (BMI), hemoglobin A1c, triglyceride, total cholesterol, blood cortisol and plasma aldosterone levels were also obtained.

Fasting Before Contrast-Enhanced CT May Not Be Necessary for Some Patients

The results showed that all patients demonstrated a significant correlation between CT attenuation and each of CCR, BMI and blood cortisol levels. The 24 patients with primary aldosteronism and 1 with non-functioning AA also showed a significant correlation between CT attenuation and CCR or BMI.

The researchers concluded that lipid-metabolism-related factors including BMI and blood cortisol levels can affect unenhanced CT attenuation of AA in addition to pathological factors.

CT attenuation also affected by BMI and blood cortisol levels.

Lipid-Metabolism-Related Factors Affect Unenhanced CT Attenuation of Adrenal Adenoma

Coronary computed tomography angiography (CCTA) plus computed tomography-derived fractional flow reserve (FFRCT) improved assessment of coronary artery disease (CAD) severity, according to a study published in the journal 

Researchers from the United States and Germany performed a quality-improvement study to assess the impact of FFRCT on reader confidence and interpretation reader time of CCTA.

Fifty patients, 23 of whom were women, participated in the study. Mean age was 67 years and body mass index 28.7 kg/m

. CCTA was acquired on 2nd and 3rd generation dual-source MDCT with use of beta-blockers and nitroglycerin. Four readers participated, two with experience level COCATS2 (Core- Cardiology-Training-Symposium) and two with COCATS3 assessed severity of epicardial CAD using CCTA alone and CCTA with FFRCT. They rated reader confidence for CAD and the four major epicardial coronary artery vessels were measured for hemodynamically significant stenosis (HS) on a 4-point Likert-scale, ranging from 1 being high and 4 being none. Time to interpret was also recorded.

Coronary CTA really works, but why isn't its use soaring?

The results showed the severity of CAD in the cohort population as per the CAD-RADS (Coronary-Artery-Disease Reporting-and-Data-System) was:

Sixty-three CA in 30 patients had minimal FFRCT values of 0.8 or less. Reader confidence when using FFRCT increased for CAD and HS. A reduction of non-confident patient read by 27% for rank 3 and 75% for rank 4. The change in confidence was associated with reader experience, but not CAD-RADS. The median time-to-read a CCTA study decreased by 5 minutes when FFRCT was available.

The researchers concluded that there was improved reader assessment for assessment of severity of CAD and HS when CCTA was used in conjunction with FFRCT. There was a reduction of non-confident reads and there was a decrease in the median time-to-interpretation of a CCTA.

Imaging method reduced non-confident reads, decreased time.

Author | Diagnostic Imaging Staff

Articles

Diffusion-Weighted MRI Can Characterize Pulmonary Lesions

MRI May Help Determine Return to Play After Adductor Longus Injury

Lipid-Metabolism-Related Factors Affect Unenhanced CT Attenuation of Adrenal Adenoma

CT-Derived Fractional Flow Reserve Improves Assessment of CAD